The purpose of this study is to determine the toxicity and efficacy of sequential topotecan administered as a 72 hour infusion followed by daily etoposide in patients with relapsed or refractory acute myeloid leukemia. The objectives are to determine the maximum tolerated dose and to describe the toxicity. Eight patients have been enrolled. Seven patients had no change in their disease and one patient was taken off study at the physician's discretion. Patients are currently being treated at dose level 2. The trial will continue to accrue patients.